| NPI | 1174068464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOLLY ROGERS Onsite Supervisor 360-751-5096 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-14-17447) |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services (Licence: WA CL60641699) |
| Enumeration Date | 2016-12-22 |
| Last Update Date | 2016-12-22 |